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What mediators need to know about mental health

Q&A with Arabella Tresilian, Associate Mediator, Medical Mediation Foundation

At the Civil Mediation Council Conference 2020, the Medical Mediation Foundation’s Arabella Tresilian was interviewed by expert mediator Carolyn Graham on what mediators need to know about mental health and mediation. Here are some of the key takeaways from their conversation.

[Please be aware that this article covers some sensitive topics and reader discretion is advised.]

What brings you to mediation with a specialist interest in mediation and mental health?

For twenty years I worked as a consultant in management and organisational development in the public and corporate sectors, with a specialism in mental health and social inclusion. In this work, I saw the stress and distress caused by conflicts and disputes and this initially piqued my interest in mediation.

I also have lived experience of mental ill-health going back to my teenage years, and in my late thirties I received a diagnosis of autism that helped me understand my unique neural wiring. A few years ago, I was particularly unwell with regards to my mental health, and encountered a series of legal and financial disputes as a result - leaving me even more emotionally devastated. It confirmed my belief that there must be a better way for resolving disagreements than via legal wrangling, and I decided to retrain as a mediator specialising in cases involving individuals experiencing mental ill-health.

I now mediate in Court of Protection, workplace, employment, civil and community cases, where mental ill-health is or may be a feature of the mediation. I also work with Mind and Bath Mind to train groups in Mental Health First Aid, to encourage positive dialogues about mental wellbeing at work and in the community. I always emphasise that I’m not a clinician, but I speak as a lay person keen to support a better societal understanding of mental health.

Reflections of a soon-to-be Consultant: How mediation changed my career.

by Dr Gamunu Ratnayake

“Urgh that family is so difficult, I hate dealing with them!”

“This patient is such hard work, why won’t they just listen!”

“I don’t understand why they are going against my advice, if they did what I suggested it would be so much better for them.”

“I’m pretty sure that family is going to make a complaint.”

“He/She is so difficult to work with.”

“They are so unreasonable!”

“I hate working with that team!”

Over the last 13 years I have had the privilege of working as a Respiratory and Intensive Care registrar before re-training as an Anaesthetist. I am currently an ST7 in Anaesthetics at the Evelina Children’s Hospital. I found out about mediation quite by accident. I was interested in Medical Law and was considering a conversion course. Whilst discussing the conversion course with a lawyer, they mentioned that many of their most successful cases never got to court. Instead by using mediators, they took antagonistic (even hostile) situations between families and clinicians and resolved them so that both sides felt heard and understood. This sounded like the Holy Grail to me. So I embarked on training as a mediator, to learn these transformative skills.

Using Townhalls to generate engagement in a clinical team

One of the most common features we come across when working with clinical teams is an imbalance of voices. We are often asked to help redress that imbalance and bring about a more open, inclusive and fluid culture of communication.

Townhalls are really effective at kickstarting this process.

Speaking up and making their voices heard can be a real challenge for some members of a clinical team.

Often, the imbalance stems from where power is located within a group. Power can emanate from experience, seniority, hierarchy, background or personality (or a myriad of other places).

Those with the power are often unaware of their impact on those that don’t. The effect can be that certain people dominate proceedings, whilst others find themselves mute at the fringes.

There is a cost to losing those quieter voices.

Recalibrating Communication for healthcare teams

Transparent Leadership

Since lockdown began, we have run online support and training sessions for almost 1,000 NHS staff.

Our experience confirms the research; when the established status quo is threatened, teams need to be communicated with differently.

Team members need communication that is not only more frequent, tailored and specific, it also needs to major on anxiety containment and horizon scanning. Team members need to feel more supported and ‘held’ through the uncertainty.

Old school management doesn’t work here; the ‘command and control’ style of communication, with information cascaded down as and when you consider it necessary is a poor fit for today’s world.

Particularly in times of uncertainty, people become acutely aware of what they don’t know, what they can’t see, and what could be lurking in the areas of uncertainty. You have the opportunity to do your team a great service by revealing to them parts of the map that you can see, but they can’t. What might you have knowledge of, that others don’t, that they would really appreciate knowing?

So – how can you do it? A great first port of call is the ‘Transparency Checklist’.


Cultivating compassion in challenging times

As we navigate the uncertainties of the coronavirus pandemic, it can feel harder to be compassionate than usual but our desire to do so – and the need for compassion – is probably greater than ever. Understanding of the science and benefits of compassion can help us, based on work from international researchers, see Stephen Trzeciak and Anthony Mazzarelli and Kristin Neff

Here are 6 fundamental considerations when it comes to compassion:

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